Talking to a CNM

SiennaGreen · Oct 2, 2009

You may have to do some networking in your community. If you are unfamiliar, this will be intimidating, but I will tell you from experience that most MW's I know are very willing to discuss their job and roles with up and coming students. understand, often times their time is very precious; so you must be as flexible as possible. Some thoughts:

1. Find Childbirth/Parenting/Breastfeeding oriented groups that might meet in your town. You might not meet MW's there, but you will meet women who utilize them and get some good recomendations.

2. Find out the names of the CNM's locally (it isn't too hard, just dig a bit or check the ACNM web site for a listing of local MW's) and write them a nice note, explaining succcinctly what you're hoping to accomplsih w/a brief (20 minute) appt, and then tell them you will be contacting them by phone on such and such date. Then do so. If they are unable, they will tell you. Be prepared to offer to bring lunch next time they are on a shift.

3. You can also check the Mothering.com forum and the Midwiferyoday.com forums.

Good luck!

midwife228 · Oct 12, 2009

I am sure that any local midwives you contact will be willing to give you information. I am a practicing CNM and would also be willing to answer whatever questions I can. I am currently a staff midwife in a large hospital but have previously worked in 2 very different private practices.

what2donow · Oct 13, 2009

Midwife228- Thank you so much for your reply! I decided to shoot you some questions here on this forum (rather than private message), as I'm sure there are others out there who'd like to hear about your experiences. If you'd rather not post here, please PM me. Although, I haven't used that function before and hope I could figure it out! Anyway, I would love to hear about your work experiences and how they differed from place to place. In particular, I really want to know what kind of work schedule a midwife can expect. How many office hours? How much call? How many hours per week? Is it possible to have a family life and be a CNM, or is it something that you have to feel so passionate about that you are willing to sacrifice time with your family? And do you think you are compensated appropriately for the important work you do?

Have you found much tension between yourself and the OBs you work with, or is it collegial?

I guess I will stop there. I truly appreciate your willingness to answer my questions!

midwife228 · Oct 13, 2009

I have had 3 very different employment experiences and I will try to share them briefly. I am certainly willing to share more details by PM if you want; I have not tried that from this site either but am willing to.

My first midwifery position was in a private practice that was physician-owned. I was scheduled for 32 hours a week in the office (add about 1/2 to 1 hour per day for going over lab results, returning phone calls, etc.) and a 24-hour call, as well as 1 in 3 weekends on call. The other midwife and I also did 1 in 2 call for women who wanted a midwife specifically for their birth (this was a practice that offered the option of physician or midwife for delivery). I also on occasion made private arrangements with clients to be available for their birth. I "lived" in a call room at the hospital whenever I was on call, as I lived 45 minutes away. Fortunately, my children were grown adults by that time.

My second midwifery job was in a small community hospital, closer to home, in a hospital-owned practice. This was my "dream job" - at the hospital I had always wanted to work in - but turned out to be otherwise. I was hired to what was going to be a 4-provider practice, 2 docs and 2 midwives. One of the docs was finishing her residency so the other midwife (who I absolutely loved working with) and I offered to split the call until the second doc came; then it was to be 1 in 4 call. Between the time we signed our contracts and the time I started, the 1 physician had taken another job and the hospital quick hired a women physician who, it turned out, did not want to work with midwives although that is NOT what she told them when they hired her. She undermined us personally and professionally every day. When the 2nd doctor came, the on-call schedule never changed. They never would agree to take call, other than to back us up, and the hospital Administration never made them do it. The other midwife left after about a year of this; I stayed about another year and a half after she left (call me stubborn, I guess, but I really wanted it to work out).

My current job is as a staff midwife at a large teaching hospital (where I worked as a L&D nurse for many years). I do triage and "manage labor" until the docs decide to breeze in and catch babies. Once in a long while I get to catch a baby if a doctor isn't going to get there in time. I also help to teach resident physicians, hopefully teaching them a more midwifery model of care. I do feel that I have a collegial relationship with physicians here, although that is probably partially because they have known me for many years and respect my judgment. I also feel that I am paid appropriately here but I have to qualify that by saying that there is a Union at this hospital and a large part of my appropriate pay is because I have worked here for many years. I do not feel I was ever paid appropriately in private practice and I used salary.com in negotiations with little effect. Private practice midwifery jobs are few and far between in my area because the malpractice insurance has gone through the roof - in the 9 years that I have been a midwife it has gone up 100% and there is no provision for part-time midwifery. Most practices who have midwives only have them work as practitioners in the office.

I never would have thought that I would be in this position at this relatively early point in my midwifery career. Under more favorable circumstances I would have happily continued being on-call for several more years. However, we have to do what we have to do and so, while I miss births and the relationships I had with my clients enormously, I comfort myself with knowing that I am (hopefully) contributing to the next generation of providers who will have been taught another way of doing things and with the fact that I work three 12-hour shifts now and am never on call so I have lots of time to spend with my grandchildren. Speaking of which, you asked about job/family time conflicts. I would suggest that if you have a young family you should look for a large group practice to limit your on-call time. My children were grown when I went back to school but I would think it would be nearly impossible to be on the schedules I have been on if they had been younger.

I'm sorry, this is a very long post. Hope it has been helpful and not just rambling. I will be glad to try to PM if you want. I hope to hear back from you and good luck with your midwifery career!

BABYCATCHERCNM · Oct 15, 2009

I went back to school to become a CNM when my first-born was 3 months old...she is now 23 years old and in her 1st year of medical school...I also had 2 more children while in school...and have worked part-time at first and then full-time as a CNM since... so I think I understand your concerns. Yes, you can be a CNM with a young growing family..if you and your family and/or support people are flexible. Midwifery school is probably the biggest hurdle timewise, as your schedule of didactic and clinical hours will change with the semester. Once out of school..it helps ALOT if you live in or near a big city, as your options will expand. You can work in a large inner-city midwifery group with many other CNMs and have a stable schedule of office and labor and delivery hours each week..on either a part or full time basis. I worked one Tuesday office day, and (because my hubby was home) 2-12 hour weekend night shifts in L and D...for the first few years. No we had no social life for those years, but the kids were well cared for mostly by myself and my hubby (whose support was invaluable), I was doing work I loved, and getting a GREAT education working with a large group of very diverse midwives. Then, the kids got older and more responsible and I moved into private practice, which is what I truly love. I have been in 2 small practices in the last 14 years, as 1 of 2 or 3 midwives...which means on call weekends every 2-3 weeks and about 20 hours of office each week. Do I work more than 40 hour weeks now...yes infrequently...do I work some 30 hour weeks...yes, again infrequently. I think being flexible...having the ability to get by some days on just a few hours of sleep...being able to get back to sleep instantly after several middle-of-the night phone calls...and loving what you do makes it more than worthwhile. You can make this career move with a young family...all you need is a real passion for the profession...some flexibility and support...and a great sense of humor when all else fails(and you know it will at sometime). Go with your heart...and have no regrets!

Bree124, BSN, RN · Oct 16, 2009

Thanks, ladies! It's so great to hear from people who are practicing. Very encouraging!

what2donow · Oct 19, 2009

Thank you for taking the time to answer my questions!!!

byrd262, BSN, RN · Jan 14, 2010

Honestly, if I were you, I would schedule an annual GYN exam with a local office with CNMs. Find out if any practices exist where you live with CNMs and then schedule your appointment as you normally would and gradually ask your questions. You don't have to make this your main GYN. Just make sure they take your insurance.

If you are a nursing student (especially in a large city), find out if your L&D clinical sites have CNMs. My school gave us a list to choose of sites (no guarentee, of course.) I chose the site with the most CNMs. Now, as a doula, I go to that facility every once and a while and 3 of the CNMs know me.

kitchenluvr · Jan 23, 2010

Thank you to the midwives that shared their stories with us! I really appreciated that! I am currently a Frontier student with 1 out of 3 years completed. Before applying to school I found myself trying to do the same thing- get in touch with some CNMs about their education, work, and family experiences. I literally called offices and left phone messages stating the reason for my call or, better yet, emailed them directly when they had an email or "contact us" section of a practice website. I had a lot of email and call back responses and everyone was more than happy to answer questions and tell some stories. My advice is dont be shy and just ask away! Good luck!